Urology Coding Alert
Approach Is Key in Renal Cryoblation Coding
Illinois Subscriber
Answer: How you report renal cryoblation depends on the approach your urologist takes. If the physician performs the procedure via a laparoscopic approach, use 50542 (Laparoscopy, surgical; ablation of renal mass lesion[s]). If your doctor uses sonography for guidance or to monitor the response of the renal lesion to the cryoblation, you should also report 76940-26 (Ultrasound guidance for, and monitoring of, visceral tissue ablation; professional component).
If the urologist performs the procedure via an open or percutaneous approach, report the unlisted-procedure code, 53899 (Unlisted procedure, urinary system). Again, add 76940-26 if the physician uses ultrasound guidance or monitoring. If he uses CT guidance, you should also report 76362-26 (Computed tomography guidance for, and monitoring of, visceral tissue ablation; professional component).
For some private payers, especially Blue Cross/Blue Shield, you may be able to report HCPCS codes S2090 (Ablation, open, one or more renal tumor[s]; cryosurgical) or S2091 (Ablation, percutaneous, one or more renal tumor[s]; cryosurgical). These codes are not appropriate for Medicare, and you should check with your individual carriers before using them.
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